Twenty five years after an amendment to the National Organ Transplant Act made it illegal for HIV-positive Americans to receive organ transplants from HIV-positive donors — or to even conduct research on such transplants — a bipartisan group of senators is hoping to reverse course.

Sens. Barbara Boxer (D-CA) and Tom Coburn (R-OK) introduced the HIV Organ Policy Equity (HOPE) Act in the Senate on Thursday to “establish a regular review process in which the Health and Human Services (HHS) Secretary would evaluate the progress of medical research” into organ transplants between two HIV-positive people, with the eventual goal of eliminating the ban on such procedures entirely.

The amendment that led to the current ban was a consequence of the poor understanding of HIV/AIDS-related matters at the time. But as Coburn — who is a physician — said in a press release introducing the legislation, “Our scientific understanding of AIDS is much better than when this research ban was established. Those infected with HIV are now living much longer and, as a consequence, are suffering more kidney and liver failures. If research shows positive results, HIV positive patients will have an increased pool of donors.”

The number of HIV-positive patients successfully receiving liver, kidney, and heart transplants has been on the rise overall, as there is no formal law prohibiting HIV-positive patients from receiving organs from Americans who do not carry the virus. But the new push to end the ban on transplants between two HIV-positive individuals reflects the huge strides in HIV treatments and medical innovation over the last two decades, including the recent FDA approval of a once-a-day HIV treatment pill and vastly increased life expectancy for HIV-positive Americans.

Opening up avenues for organ transplants is especially critical given America’s unsustainable dearth of annually performed transplant operations, which leaves more than 70,000 Americans on transplant lists without the organs they need every year. “With so many lives at stake, it is time to end this outdated ban on research into organ donations between HIV-positive individuals,” Boxer said in the release. A concurrent bill has been introduced in the House of Representatives by Congresswoman Lois Capps (D-CA), a registered nurse.

High-profile Democratic women are hitting back against the GOP’s opposition to the Obama administration’s new rule requiring insurers and employers to offer contraception in their health care benefit plans. Obama exempts houses of worship and nonprofits that primarily employ people of the same faith from covering birth control, while religiously affiliated hospitals and colleges can also eschew the benefit. Their employees would obtain the coverage — at no additional cost sharing — directly from the insurer.

Today, the Senate will hold a vote on a Republican substitute introduced by Sen. Roy Blunt (R-MO), which would allow any and all insurers and employers to deny their employees health benefits and services required by federal law based on their personal religious or moral objections. The measure has 37 co-sponsors — including the GOP leadership, women Republican Senators Lisa Murkowski (AK), Kay Bailey Hutchison (TX), Kelly Ayotte (NH), Democrat Ben Nelson (NE), and Republican Scott Brown (MA). Brown has supported expansive conscience protections for religious organizations throughout his legislative career, but voted for a tougher contraception mandate as a Massachusetts state representative in 2002 and approved of a law requiring all hospitals — including Catholic institutions — to provide emergency contraception to rape victims in 2005.

After defending Obama’s rule last year, Democrats are now on the offensive. Sens. Barbara Boxer (D-CA) and Patty Murray (D-WA) have derided Blunt’s measure as “extreme” and “dangerous,” claiming that “It puts politics between women and their healthcare.” Sen. Jeanne Shaheen (D-NH) warned, “This would gut the protections that were established in the Affordable Care Act and open a Pandora’s box that allows employers to deny coverage for virtually anything they might object to” and yesterday, Massachusetts Senate candidate Elizabeth Warren told the Washington Post’s Greg Sargent that amendment would permit insurers or employers to discriminate against women:

“I am shocked that Senator Brown jumped in to support such an extreme measure,” Warren told me by phone just now. “This is an all new attack on health care. Any insurance company could leave anyone without health care, just when they need it most.” [...]

“This is an extreme attack on every one of us,” Warren said. “It opens the door to outright discrimination. It would let insurance companies and corporations cut off pregnant women, overweight guys, older Americans, or anyone — because some executive claims it’s part of his moral code. Maybe that wouldn’t happen, but I don’t want to take the chance.”

Indeed, under the measure, an insurer or an employer would be able to claim a moral or religious objection to covering HIV/AIDS screenings, Type 2 Diabetes treatments, cancer tests or anything else they deem inappropriate or the result of an “unhealthy” or “immoral” lifestyle. Similarly, a health plan could refuse to cover mental health care on the grounds that the plan believes that psychiatric problems should be treated with prayer.

Individuals too can opt out of coverage if it is contrary to their religious or moral beliefs, radically undermining “the basic principle of insurance, which involves pooling the risks for all possible medical needs of all enrollees.” As the National Women’s Law Center explains, Blunt’s language is vague enough that “insurers may be able to sell plans that do not cover services required by the new health care law to an entire market because one individual objects, so all consumers in a market lose their right to coverage of the full range of critical health services.” As a result, a man “purchasing an insurance plan offered to women and men could object to maternity coverage, so the plan would not have to cover it, even though such coverage is required as part of the essential health benefits.”

Significantly, two Republican women senators — Olympia Snowe (ME) and Susan Collins (ME) — have come out in support of Obama’s modified contraception rule and may oppose Blunt’s measure.

Read the full amendment here.

Fatima Najiy contributed to this post.

Yesterday, the Senate Committee on Commerce, Science, and Transportation held a hearing about the administration’s decision to exempt so-called mini-med plans — subprime insurance offered to lower wage employees — from certain requirements in the Affordable Care Act that are intended to protect Americans from insurance abuses until they can purchase more comprehensive coverage from the state-based exchanges in 2014. Democrats criticized employers like McDonald’s — which had warned federal regulators that it could drop its health-insurance plan for 30,000 hourly workers unless regulators waived certain requirements — for selling insurance that “give workers a false sense of protection from expensive illnesses” and argued that “workers would be better with no coverage at all since they could redirect their premiums to spending on their medical care.” Mini-med insurance plans often restrict the number of covered doctor visits or impose a relatively low maximum on insurance payout and beneficiaries often have “no idea of how limited the coverage is.”

During one exchange with Richard Floersch, McDonald’s Corporation Executive Vice President and Chief Human Resources Officer, Sen. Barbara Boxer (D-CA) highlighted the discrepancy between how much the company contributed to the health plans of its lowest wage workers — who presumably would have the hardest time keeping up with growing health care costs — and corporate executives:

BOXER: Mr. Flourish, what percentage of these low income peoples’, health care plans do you pick up? [...]

FLOERSCH: Anywhere from 10 to 20% of the hourly employees that we’re talking about.

BOXER: Okay. What do you pick up for your corporate people?

FLOERSCH: We pick up 80% for our corporate people. We pick up 80% for our restaurant managers. We pick up 80% for our certified swings….70% of for our executives [...]

BOXER: Explain that to me. The people who earn the least you pick up the least of their premiums… you are telling me with a straight face that an hourly employee could afford the same level of coverage that you get? No. And what you do is, you pick up hardly anything of the lowest income people and if you look at — Do you know what, for example, starbucks pays for its workers? 75%.

Watch it:

Boxer suggested that the company could afford to pay a higher percentage towards the health care of its lowest wage employees, noting that the company posted a $4.5 billion profit in 2009. “I’m just saying that you pick up 70 to 80 percent of your higher income workers and 10 to 20 per of your lowest workers,” she said.